Abstract: Chronic heart failure is the terminal stage of progressive aggravation of various cardiovascular diseases, and as an independent risk factor for heart failure, senility can increase the prevalence rate. Ventricular remodeling is the main pathological and physiological basis of chronic heart failure, and in addition to changes in the activities of inflammatory reactions and related cytokines, factors such as metabolic disorders of myocardium, regulation of myocardial extracellular vesicles, and imbalance of intestinal microbiota also play important roles. This paper provided an overview of the research progress on ventricular remodeling mechanism in elderly patients with heart failure.